Levaquin Side Effects: Generic name is levofloxacin. Dosage forms are available as 250, 500 and 750 mg capsules, as a 20 mg/ ml oral liquid, and for IV administration. Levaquin is an antibiotic in the class known as fluoroquinalones, and is used to treat bacterial infections. Levaquin has activity against a broad spectrum of both gram positive and gram negative bacteria and is used to treat pneumonia, prostatitis, kidney infections, acute sinusitis, skin infections, simple urinary tract infections, as well as anthrax and other infections.
Black Box Warnings: Levaquin, like other fluoroquinalones, can cause tendon rupture. Although this can happen in people of all ages it is more common in those over 60 years old, and in patients taking corticosteroid medications or who have organ transplants.
Common Levaquin Side Effects: Most people who use Levaquin have no Levaquin side effects, but a fairly common Levaquin side effect is tendinitis (note: if you get tendon pain this may be a sign of impending tendon rupture, and you should stop taking the medication and see your health care provider). Gastrointestinal Levaquin side effects including nausea, vomiting, diarrhea, constipation, acid dyspepsia, and abdominal pain are listed as common. Headache, dizziness and insomnia are additional fairly common Levaquin side effects.
Serious Levaquin Side Effects: The manufacturers list of serious potential side effects is extensive. Tendon rupture, especially Achilles tendon rupture is a unique fluoroquinalone side effect that Levaquin shares with the other medications in this class. In many communities a bowel infection with C. difficile is increasingly common that is caused by use of many antibiotics including Levaquin. C. difficile colitis typically causes bloody diarrhea, abdominal pain, and can be life threatening. Other serious Levaquin side effects can include serious allergic reactions like anaphylaxis and vasculitis, various bone marrow disorders including myelosuppression and other blood dyscrasias, kidney and liver toxicity that can be fatal, an unusual allergic pneumonitis, a serious cardiac arrhythmia called Torsades de pointes and peripheral neuropathy. See the manufacturer’s prescribing information for a more complete list of potential serious side effects.
Unusual Levaquin Side Effects: The tendonitis and tendon rupture Levaquin side effects are unique to the fluoroquinalone class of antibiotics. This class includes ciprofloxacin, moxifloxacin, and ofloxacin among others.
Drug Interactions: The list of drug interactions with Levaquin is extensive, and is far too long to list here in detail. See the manufactuer’s prescribing guidelines for complete details and consult your physician or pharmacist for specific drug interaction questions. Especially important drugs where Levaquin is contraindicated for concurrent use are the class Ia and class III anti-arrhythmics and the phenothiazine class of medications. These interactions can be associated with higher incidence of serious arrhythmias and cardiac arrest. Warfarin is a noteworthy drug interaction as persons using warfarin can have dramatic increases in the prothrombin time (a monitor of the degree of anticoagulant effect) and may need to alter their warfarin dose if used together. Several of the commonly subscribed HIV drugs can have serious drug interactions with Levaquin. Concurrent use with corticosteroid medications may increase the risk of tendon rupture. Overall the fluoroquinalone class of medications has an extensive list of drug-to-drug interactions and is worth checking when used with other medications.
Pregnancy and Lactation Class: Levaquin is a category C drug in pregnancy, and is considered probably safe for use during lactation.
Special Considerations: Many experts consider levaquin to have a higher propensity to induce antibiotic resistance than some of the other fluoroquinalone medications, and recommend against use of levaquin in situations where ciprofloxacin is a viable alternative drug in this class. Examples are for urinary tract and prostate infection, where Ciprofloxacin is often considered a better alternative. In patients using other medications evaluation of the potential for drug interactions is important given the extensive list of potential drug to drug interactions.
Antibiotic resistance is a common problem in medicine today. Many experts recommend avoiding use of the fluoroquinalone class of medications for conditions where alternative antibiotics can be effectively utilized both to save these drugs for the less common serious indications as well as because the development of resistant bacteria is felt increased by widespread use of drugs like Levaquin.
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